medical school to graduate school transition
One reader asked today:
I am a current MD/PhD student in my first year of med school. I am just curious about your thoughts on making the transition to grad school after 2nd year vs. after 3rd year. I lean toward going into grad school after 3rd year and am trying to convince my program that it would be better for me to do it that way. I would just like to hear an outside opinion!
I guess it would make sense that if I wrote about the graduate school to medical school transition, then I would have also written about the medical school to graduate school transition that mudphudders face. I had sort of glossed over this because usually the medical school to graduate school is such a welcomed change of pace.
As I have probably written before, the endless memorization of medical school “learning” can lead to significant rust in terms of ”thinking” so most mudphudders welcome the transition to graduate school. One problem that can arise is referred to by this reader’s question. Namely, when to break away from medical school to start graduate school. I’ve known mudphudders who have started graduate school after the first, second, third and fourth years of medical school. My recommendation is to either do it after the second or third years of medical school. Second year of medical school tends to be pretty brutal at many institutions so having to come back to that from graduate school (i.e. if you left after the first year of medical school) can be a stone cold rude awakening. Every mudphudder I know who has come back from graduate school to second year of medical school has found it to be an unpleasant experience. The flip side is that there is complete continuity between the immense knowledge gained during second year into the clinical years. But I’d still advise against it. Doing the PhD after the fourth year should only be done if you have to do it that because of life-planning reasons, etc. That’s not ideal for obvious reasons so I won’t get into it.
So how to decide between starting graduate school after the second or third years of medical school? Most mudphudders do it after the second year. I think there’s a natural break there that lends itself to a smooth transition to graduate school: finish courses, may be do a couple of clinical rotations, take USMLE Step 1 (this is a MUST) and then hit graduate school. I did it that way and I have no complaints. Some mudphudders leave after the third year. This is a little unconventional but definitely not unheard of. The advantage of that is you get more clinical experience and hopefully figure out what field of medince you want to go into before you start the PhD. And when you go back to the wards, you won’t have to scramble to figure that all out. The mudphudders I know who started graduate school after the third year of medical school all wanted to gain more clinical experience and find their clinical passion before graduate school so that knowledge would inform what field they would study in graduate school and even what question to study for their dissertations. I think that is a very valid reason for finishing third year of medical school before starting graduate school. The disadvantage is mostly on the tail end of things. When you go back to medical school after finishing the PhD, you will be a fourth year. A lot is typically expected from a fourth year medical student so you will be under a lot more pressure to perform when you go back. As a third year, it’s a lot easier to use the “I just came back from my PhD (i.e. I don’t remember jack)” card than it is as a fourth year. Moreover, if you have sub-internships to do as a fourth year, that becomes even harder if your basic clerkship was 4 to 5 years ago. Or if you managed to get the sub-internship done before starting graduate school, you will still have to do another sub-I to prove to the residency committees that you still got what it takes. Either way, it will be more difficult than coming back as a third year. But definitely not insurmountable as evidenced by the number of mudphudders who have successfully done it this way. Also, after a few months back anyway, everyone is essentially accustomed to being on the wards.
The bottom line in deciding when to go start graduate school as a mudphudder will come down to how much clinical experience you need before graduate school. I say “need” instead of “want” because this experience should be for a strategic reason–e.g. so you can tailor your PhD to a particular field. If you can present a cogent argument in those terms for starting graduate school after any particular year (1st, 2nd or 3rd) of medical school, then your program should–in theory–have no problems with it. It’s safest (in my opinion) to start after second year but think about your own needs/plans for the future and do what’s best and most strategic in that regard.